The Influence of Porphyromonas Gingivalis Bacterium Causing Periodontal Disease on the Pathogenesis of Rheumatoid Arthritis: Systematic Review of Literature

Abstract

Periodontal pathologies are highly widespread throughout the world. Epidemiological studies have shown that as much as 1% of the population is suffering from periodontal disease. In recent years, there has been a growing number of studies linking these diseases with autoimmune diseases, especially with rheumatoid arthritis. This literature review evaluates changes in the relationship between periodontal pathologies caused by the bacterium Porphyromonas gingivalis and rheumatoid arthritis. The systematic review of the literature was performed according to the PRISMA analysis protocol. The review was performed with articles from the PubMed database. Searched articles were not older than 5 years. Only full texts and research performed with people were selected. A total of 56 results were received. A review and analysis of their full texts have been carried out and 10 articles were selected according to the established criteria. They were analyzed and results were presented. The results obtained from the literature were based on the influence of Porphyromonas gingivalis on the pathogenesis of rheumatoid arthritis. In the literature, the activity of this bacterium is explained by the analysis of its enzyme peptidylarginine deiminase and its principle of action. Studies have also been found to prove the presence of Porphyromonas gingivalis not only in the oral cavity but its DNA is also found in synovial fluid and plasma. In the researched articles, direct links between Porphyromonas gingivalis and rheumatoid arthritis have led doctors to draw attention to patients' oral hygiene and the condition of parodentium, as this may be the cause of autoimmune lesions. Treatment of periodontal disease will not only help maintain a healthy oral cavity but prevent the spread of bacteria to the surrounding tissues.

The Role of Porphyromonas gingivalis Outer Membrane Vesicles in Periodontal Disease and Related Systemic Diseases

“…The PPAD enzyme produced by P. gingivalis not only disturbs the balance of amino acids, but also destroys the entire body's immune system. It makes the Ag/Ab complexes imbalance, and the human body produces citrullinated antibodies against self-antigens ( Kriauciunas et al, 2019). Gabarrini et al found that PPAD can be associated with OMVs and modified by A-LPS to protect PPAD from proteolytic degradation (Gabarrini et al, 2018).…”

“…In contrast, health-related species are at a disadvantage under this environmental condition, causing imbalances and further exacerbating inflammation, which eventually results in individual periodontitis ( Lamont et al., 2018 ). At the same time, P. gingivalis can be detected in other sites such as synovial fluid and plasma, suggesting its potential correlation with systemic diseases ( Kriauciunas et al., 2019 ). It can also interact with the host to promote gene enrichment related to Alzheimer’s disease, diabetes and cardiovascular disease, and even aggravate inflammation at the level of the central nervous system, which is conducive to the occurrence of diseases ( Carter et al., 2017 ; Dioguardi et al., 2020 ).…”

Evaluation of Trans-Resveratrol as a Treatment for Periodontitis

“…DNA sequences from Pg have been isolated from the synovial fluid and bloodstream of patients with rheumatoid arthritis (RA). Further to this, the consistently reported relationship between an oral Pg infection and RA has encouraged medical clinicians to place more emphasis on the oral health of their patients [71].…”

Response of Different Treatment Protocols to Treat Chronic Non-Bacterial Osteomyelitis (CNO) of the Mandible in Adult Patients: A Systematic Review

“…This is difficult to reconcile with the assumed pathomechanism of the disease. Possibly, the positive effect of antibiotics observed by some authors is related to the fact that in patients with rheumatic disorders, antibodies of anaerobic microorganisms, especially periodontal bacteria, may be increased [31]. However, the approach that seems to be more appropriate is that some antibiotics, especially those that are repeatedly discussed for the treatment of rheumatic diseases, have anti-inflammatory partial effects that run independently of their anti-infective effects [32].…”